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Radiotherapy volume delineation using dynamic [18F]-FDG PET/CT imaging in patients with oropharyngeal cancer: a pilot study

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Delineation of gross tumour volume in 3D is a critical step in the radiotherapy (RT) treatment planning for oropharyngeal cancer (OPC). Static [18F]-FDG PET/CT imaging has been suggested as a method to improve the reproducibility of tumour delineation, but it suffers from low specificity. We undertook this pilot study in which dynamic features in time-activity curves (TACs) of [18F]-FDG PET/CT images were applied to help the discrimination of tumour from inflammation and adjacent normal tissue.

Methods

Five patients with OPC underwent dynamic [18F]-FDG PET/CT imaging in treatment position. Voxel-by-voxel analysis was performed to evaluate seven dynamic features developed with the knowledge of differences in glucose metabolism in different tissue types and visual inspection of TACs. The Gaussian mixture model and K-means algorithms were used to evaluate the performance of the dynamic features in discriminating tumour voxels compared to the performance of standardized uptake values obtained from static imaging.

Results

Some dynamic features showed a trend towards discrimination of different metabolic areas but lack of consistency means that clinical application is not recommended based on these results alone.

Conclusions

Impact of inflammatory tissue remains a problem for volume delineation in RT of OPC, but a simple dynamic imaging protocol proved practicable and enabled simple data analysis techniques that show promise for complementing the information in static uptake values.

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Acknowledgments

We thank Rikard Owenius, PhD for our ability to learn from each other in this and a related project. We also thank the staff at Turku PET Centre and the Department of Oncology and Radiotherapy in Turku University Hospital. This study was supported in part by the Cancer Foundation in Finland, Hospital District of Southwest Finland, and the National Graduate School of Clinical Investigation.

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Authors and Affiliations

  1. Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland

    Antti Silvoniemi

  2. Turku PET Centre, University of Turku, P.O. BOX 52, 20521, Turku, Finland

    Antti Silvoniemi, Mueez U Din, Tony Shepherd & Heikki Minn

  3. Department of Oncology and Radiotherapy, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland

    Sami Suilamo, Tony Shepherd & Heikki Minn

  4. Department of Medical Physics, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland

    Sami Suilamo

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  1. Antti Silvoniemi
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  2. Mueez U Din
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Correspondence to Antti Silvoniemi.

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Conflict of interest

Antti Silvoniemi, Mueez U Din, Sami Suilamo, Tony Shepherd and Heikki Minn declare that they have no conflict of interest.

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Silvoniemi, A., Din, M.U., Suilamo, S. et al. Radiotherapy volume delineation using dynamic [18F]-FDG PET/CT imaging in patients with oropharyngeal cancer: a pilot study. Int J CARS 11, 2059–2069 (2016). https://doi.org/10.1007/s11548-016-1351-1

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  • DOI: https://doi.org/10.1007/s11548-016-1351-1

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